Mental Health Psychotic Disorders What Is Undifferentiated Schizophrenia? By Heather Jones Heather Jones Facebook Twitter Heather M. Jones is a freelance writer with a focus on health, parenting, disability, and feminism. Learn about our editorial process Updated on April 06, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Definition Symptoms Diagnosis Causes Treatment Coping Undifferentiated schizophrenia is a type of schizophrenia that is diagnosed when an individual meets the criteria for diagnosis of schizophrenia but cannot be classified into any of the five defined subtypes. People who are diagnosed with undifferentiated schizophrenia exhibit symptoms of more than one type of schizophrenia. Jonathan Knowles / Getty Images Definition of Undifferentiated Schizophrenia? Schizophrenia is a mental health condition that interferes with a person's perception of reality. Previously, schizophrenia was divided into five subtypes as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association. The five subtypes of schizophrenia: Paranoid: Positive symptoms like delusions and hallucinations are most dominant. Hebephrenic/disorganized: Cognitive and negative symptoms, such as disorganized thought, disorganized speech, and flat affect are most dominant. Residual: A person meets the criteria for a diagnosis of schizophrenia, but the symptoms are in a milder form. Catatonic: A person meets the criteria for schizophrenia and has additional symptoms of catatonia (excessive movement or decreased movement). Undifferentiated: A person exhibits the symptoms of more than one subtype of schizophrenia, but does not exhibit enough symptoms of one subtype to be classified as that subtype. The most recent edition of the DSM (DSM-5) no longer includes these subtypes as distinct conditions because they were believed to have low validity and reliability in terms of diagnosis. The five subtypes are still used by some clinicians as a way to understand how an individual's experience with schizophrenia is manifesting, and as a guide for discussing prognosis and tailoring treatment for each person. Symptoms For a diagnosis of any type of schizophrenia, a person must exhibit at least two of the following symptom types, with at least one of the symptoms being delusions, hallucinations, or disorganized speech. The symptoms include: Delusions Hallucinations Disorganized speech (e.g., frequent derailment or incoherence) Grossly disorganized or catatonic behavior Negative symptoms (i.e., diminished emotional expression or avolition). Symptoms must persist for at least six months and must cause significant difficulties in the level of functioning in one or more major life areas, such as work, interpersonal relations, or self-care. Symptoms Are Not Static Symptoms of schizophrenia do not always occur all at the same time, and can change over time. People with undifferentiated schizophrenia can experience positive, negative, and/or cognitive symptoms, but their symptom pattern does not fit neatly into one of the other schizophrenia subtypes. Positive Symptoms This refers to behaviors and beliefs that are not normally present in healthy people. Positive symptoms include: Hallucinations: A sensory experience that is not real, such as hearing voices, or seeing things that are not there.Delusions: Erroneous but firmly held beliefs, despite concrete evidence that disputes the belief or a lack of factual evidence to back up the belief. This might include thinking people on TV are sending special messages or it could involve paranoia, such as thinking people are spying on them or "out to get them".Thought disorder: Unusual thinking or disorganized speech.Catatonia or other movement disorders: Excessive movement or decreased movement. Negative Symptoms Negative symptoms refer to an absence of behaviors that are considered normal. Negative symptoms include: Loss of motivationSocial withdrawalLack of interest or enjoyment in activities"Flat affect," reduced facial expression and/or vocal intonationDifficulty expressing emotionDifficulty planning activitiesDifficulty beginning and sustaining activitiesReduced feelings of pleasureReduced speaking Cognitive Symptoms Cognitive symptoms include substantial challenges with thinking skills. Cognitive symptoms include: Problems with attentionDifficulty concentrating or focusingImpaired memory, such as remembering appointmentsDiminished ability to process informationProblems with decision makingDifficulty learning and using information Diagnosis To determine if a person has schizophrenia, a mental health professional will consider several factors and diagnostic tests. Examination During an examination, a healthcare provider will: Ask about symptomsReview the person's medical historyReview the person's family medical historyPerform a physical examinationRule out other conditions besides schizophrenia Lab Tests There is no lab test that confirms or rules out a diagnosis of schizophrenia. Blood, urine, or other lab tests may be ordered to identify other possible conditions that may explain the person's symptoms. Depending on the situation, a healthcare provider may order a blood or urine test to identify the presence of medications or illicit drugs that could be causing the symptoms. Imaging Tests A magnetic resonance imaging (MRI) or a computerized tomography (CT) may be ordered if there is concern that there could be an underlying physical cause for the symptoms, such as a brain tumor. Once a diagnosis of schizophrenia is established, if the symptoms match more than one subtype but do not meet the criteria for any single subtype, a diagnosis of undifferentiated schizophrenia may be made. In this sense, the classification of undifferentiated schizophrenia is made through a process of elimination. Causes The specific cause of schizophrenia, and by extension undifferentiated schizophrenia, is not known, but there are several risk factors. Age While undifferentiated schizophrenia can occur at any age, symptoms usually begin during the age range of the late teens to the early thirties. Genetics Undifferentiated schizophrenia appears to run in families. Having schizophrenia in the family does not mean a person will develop schizophrenia, but it increases the risk. Compared to the 1% prevalence of schizophrenia in the general population, there is a 10% prevalence among people who have a biological parent or sibling with schizophrenia. The highest risk is associated with identical twins. Having a second-degree relative such as an aunt, uncle, grandparent, or cousin who has schizophrenia also increases a person's chances of developing the condition. It is likely that multiple genes are involved in the development of schizophrenia. Environment It is believed that the interaction between genetics and environmental factors influences the development of undifferentiated schizophrenia. Some environmental risk factors include: Living in povertyLiving with stressPrenatal exposure to viruses or pathogensPrenatal malnutritionHistory of abuse or neglect Substance Use Drugs do not independently cause undifferentiated schizophrenia, but some drugs have been linked to an increased risk of schizophrenia in those who are susceptible. Schizophrenia is linked most closely with use of: CannabisCocaineLSDAmphetamines Research has shown a link between excessive use of cannabis by adolescents and the subsequent development of schizophrenia. Brain Chemistry Dysfunctions of the neurotransmitters dopamine, serotonin, norepinephrine, and epinephrine have been linked to undifferentiated schizophrenia. More specifically, excessive dopamine activity is linked to hallucinations, agitation, and delusions, while abnormalities in norepinephrine are linked to negative and cognitive symptoms of schizophrenia. Brain Physiology Differences in brain structure and function are believed to play a part in undifferentiated schizophrenia. For example: Differences in the volumes of specific components of the brainDifferences in the way regions of the brain are connected and interact These brain differences may begin before birth. Schizophrenia or other forms of psychosis may be triggered by changes to the brain during puberty in those who are susceptible due to genetics, environmental factors, or brain differences. Treatment Treatment options for schizophrenia can vary from person to person. Available treatment options are outlined below. Medication Medication, particularly antipsychotics, is the most common treatment for undifferentiated schizophrenia. Antipsychotic medications can be taken in pill or liquid form, or by injection. Some antipsychotics include: Zyprexa (olanzapine)Risperdal (risperidone)Seroquel (quetiapine)Geodon (ziprasidone) Abilify (aripiprazole)Invega (paliperidone) Side effects of antipsychotics may include: Weight gainDry mouthRestlessnessDrowsiness Some people may be prescribed mood stabilizers such as: Lithobid (lithium)Depakote (divalproex sodium)Tegretol (carbamazepine)Lamictal (lamotrigine) In some cases, people with undifferentiated schizophrenia may be prescribed antidepressants such as: Prozac (fluoxetine) Zoloft (sertraline) Paxil (paroxetine) Celexa (citalopram) Lexapro (escitalopram) Effexor (venlafaxine) Pristiq (desvenlafaxine) Cymbalta (duloxetine) Wellbutrin (bupropion) Never Go "Cold Turkey" Stopping psychiatric medication abruptly can be dangerous. Always consult your healthcare provider before stopping your medication or changing your medication plan. Cognitive Behavioral Therapy (CBT) Cognitive-behavioral therapy (CBT) is a type of ongoing therapy that can be effective for treating many psychiatric conditions. With CBT, people who have undifferentiated schizophrenia can learn to identify maladaptive thought patterns and learn how to challenge them, and change the thoughts and their accompanying behaviors. Family Education and Support These programs are geared towards the family members and close friends of people who have schizophrenia. They aim to help loved ones understand the condition, learn ways to support the person who has undifferentiated schizophrenia, and find support for themselves. These programs can be done individually, as a family, or as a group with other families. Coordinated Specialty Care This type of treatment involves a team of specialists working together to provide help such as: PsychotherapyMedication managementCase managementEmployment and education supportFamily education and support It may be particularly helpful for people in an early stage of schizophrenia called first-episode psychosis. Assertive Community Treatment (ACT) ACT aims to reduce the number of hospitalizations for people with undifferentiated schizophrenia and to decrease the number of people without housing. It involves: A multidisciplinary team, including a medication prescriberA shared caseload among team membersDirect service provided by team membersA high frequency of contact with the person who has schizophreniaA low ratio between staff and the people with schizophreniaOutreach to people with schizophrenia in the community Social Skills Training This treatment uses rehearsing or role-playing real-life situations to help a person with undifferentiated schizophrenia re-learn how to act and interact appropriately in social settings. Supported Employment This program helps people with undifferentiated schizophrenia enter the workforce with support, such as assistance with constructing resumes, preparing for job interviews, and connecting them with employers who hire and support people with mental illness. Substance Use Treatment Excessive substance use can make undifferentiated schizophrenia symptoms worse. Up to 50% of people with schizophrenia have substance use disorders. Substance use treatment is often a part of the treatment program for undifferentiated schizophrenia. Help Is Available If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see this National Helpline Database. Coping Schizophrenia is a life-long condition, so finding coping strategies is important. Some helpful tips for those living with undifferentiated schizophrenia include: With the help of professionals, create and maintain a treatment plan.If prescribed medication, take it regularly as directed and do not stop without consulting a healthcare provider.Eat a healthy diet. Consulting with a dietitian may be helpful.Get plenty of exercise. Exercise is good for both physical and mental health.Manage and minimize stress with techniques such as relaxation, knowing and respecting your limits, and managing your emotions.Get plenty of sleep.Avoid substances like alcohol, drugs, and smoking.Speak with a healthcare provider about changing or adjusting medications if you are not noticing improvement or if your medications are causing bothersome side effects.Set goals and work towards them. Finding Support Living with undifferentiated schizophrenia is difficult to do alone. Having the support of others can make treatment and management of undifferentiated schizophrenia more effective, and make life with schizophrenia more enjoyable. Some ways to find support include: Reaching out to trusted friends, family, and loved onesJoining activities or groups involving things you enjoy such as sports, volunteering, or hobbiesJoining local clubs or organizationsFinding a living environment that makes you feel safe and supports your needs, whether that means living alone, community or supportive living, living with friends or family, or something elseContacting support services in your area Online Support Groups Can Be A Great Resource Some online resources for people with undifferentiated schizophrenia include: National Alliance on Mental Health 1-800-950-6264 Brain and Behavior Research Foundation: 800-829-8289 Schizophrenia and Related Disorders Alliance of America: 800-493-2094 SAMHSA Early Serious Mental Illness Treatment Locator SAMHSA Behavioral Health Treament Services Locator A Word From Verywell Undifferentiated schizophrenia can be hard to recognize and difficult to live with, but with proper support and treatment, it can be manageable. If you are experiencing symptoms of undifferentiated schizophrenia, book an appointment to see your healthcare provider or a mental health professional to get a proper diagnosis, and find a treatment plan that works for you. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 changes on the national survey on drug use and health. National Institute of Mental Health. 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